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EID News Synopsis for November 2009

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The following articles will appear in the December 2009 edition of Emerging Infectious Diseases, CDC’s monthly peer-reviewed scientific journal. Articles 1 and 2 below are expedited so available online without an embargo. Articles 3 and 4 are attached and embargoed until Nov. 11, 2009, at 12 p.m. ET.

1. Public Health Crises in 21st Century Cities

David M. Bell et al.

By 2025, almost three-quarters of the world’s population will live in cities. When millions of people are crowded together in huge cities, responses to disease outbreaks that have worked in rural areas or smaller towns may not work as well. Pandemic 2009 H1N1 flu in two megacities (Mexico City and New York City) helped health experts understand the challenges posed by outbreak response in large cities. Several questions emerged. For example, how do you get many overlapping governmental agencies to cooperate? How do you get drugs and vaccines to people who travel, live in slums with no addresses, or are homeless? How do you separate ill family members from well ones in tiny one- or two-room apartments? These are questions health experts will need to answer as the number and size of megacities continues to grow.

2. Cost-Effectiveness of Hospital Infection Control Response to an Epidemic Respiratory Virus Threat

Paul A. Tambyah et al.

When it comes to preventing the spread of respiratory infections in a hospital, is it better to adopt the most stringent measures possible or a more moderate approach? One might assume it’s best to go with the strictest measures possible, but what if prevention comes with a hefty price tag? Researchers in Singapore, a country hit hard by Severe Acute Respiratory Syndrome (SARS) in 2003, compared costs of preventing the diseases spread in hospitals of three major respiratory diseases: SARS, pandemic 2009 H1N1 flu, and the Spanish flu which caused the 1918 pandemic. They found that the severity of the virus and high case fatality rates (when a large proportion of those who get sick die) were among the things that effected cost-effectiveness the most. Researchers determined that a calibrated approach based on the severity of the virus and community risks may help guide responses to future epidemics.

Imagine a world without malaria. The world is not there yet, but new research is providing some important information about how health experts might go about eliminating malaria. Good places to start eliminating malaria are those where the disease is spread only during certain seasons, such as areas that have high altitude and dry climate. Mountainous areas often have dry seasons, when there aren’t as many mosquitoes to spread disease. Researchers recently found that in two mountainous areas of Kenya, widespread malaria control measures (such as use of bed nets treated with insecticide and treatment of malaria patients with a certain drug combination) dramatically slowed and maybe even halted malaria spread for a full year. In the future, researchers may be able to eliminate malaria from these areas through concerted efforts.

4. Age Patterns of Human Campylobacteriosis, England and Wales, 1990–2007

Iain A Gillespie et al.

Campylobacteriosis, a disease typically associated with food poisoning, is finding new victims. This unpleasant disease, which causes vomiting and diarrhea among other things, used to infect primarily children. But now, in the United Kingdom, it’s going to the other extreme and attacking mostly older people, those over 60. Food poisoning doesn’t explain why it’s becoming more common in older people. Researchers are working to try and explain this dramatic shift.